Dealing with family dynamics when a parent has Alzheimer's
Siblings have a "strength in numbers" advantage over only children when a parent develops Alzheimer's -- but for every additional family member in the mix of caregivers, there's also an increased chance of communication snafus and discord in decision-making. Here's how to keep everyone in the loop and on speaking terms:
Agree to disagree
It's a blessed but rare family where everyone is in agreement about every decision pertaining to a parent's care. Differences of opinion are liable to crop up on any number of issues, large and small. This is only logical because although you might have been born into the same family, you each have different personalities, life experiences, and relationships with your parent. Your age, marital situation, birth order, financial history, and a hundred other details inform how you see a situation. And everyone brings this baggage to the difficult situation of caring for an ill parent.
Accepting that there will be disagreements is the first step in getting along better. You may win some, you may lose some. There's rarely one right way to handle things. The primary goal is that something gets done.
Outgrow old expectations
The typical dynamic in a family crisis is for adult children to revert to their childhood roles and perceptions. Thus, for example, other siblings perceives a successful lawyer as the "baby" of the family and don't take even her legal advice seriously. Or they expect the oldest, by default, to make the hard decisions, while they exclude the "black sheep."
Be aware that sometimes the damage is self-inflicted, and we limit ourselves by slipping into our childhood roles or seeing through the lens of family history.
Another inadvertent expectation is gender stereotyping. It's not necessarily the daughter to whom care should fall, while the son handles the money.
Remember that you're all grown-ups now, and that puts you on an equal footing. Everyone involved should have a say in what transpires. If you see someone getting left out, lightly point out that it's happening and help everyone correct course. If it's your parent who clings to rigid expectations from the past, it's important for all siblings to gently set him straight.
Realize that you need one another
It's virtually impossible for a single individual to provide Alzheimer's care for the duration of the disease. That's because 24-7 care is extremely stressful, and becomes more so as the disease progresses.
If you're the sibling who is the primary caregiver, provide candid appraisals of the situation for your brothers and sisters. Learn how to ask for help; often family members don't volunteer because they aren't sure what to do and from a distance can't see how taxing Alzheimer's care can be.
If you're not the primary caregiver, it's important to support the person who is, in words and deeds (and dollars, if possible). Caregiver burnout is a leading reason people with Alzheimer's move from a home to a nursing facility. Don't assume everything's going fine: ask, visit, call. Alzheimer's is not a onetime problem to solve; because it's progressively debilitating, your parent's situation (and the kind of help she needs) can change from month to month or year to year.
